Provider Demographics
NPI:1487111241
Name:COMON, FE
Entity type:Individual
Prefix:
First Name:FE
Middle Name:
Last Name:COMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1841 E 57TH AVE.
Mailing Address - Street 2:1841 E 57TH AVE.
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507
Mailing Address - Country:US
Mailing Address - Phone:907-222-5027
Mailing Address - Fax:907-222-5027
Practice Address - Street 1:1841 E 57TH AVE.
Practice Address - Street 2:1841 E 57TH AVE.
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507
Practice Address - Country:US
Practice Address - Phone:907-222-5027
Practice Address - Fax:907-222-5027
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100592376G00000X
AL100592376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator